Plasmapheresis: Lifesaving treatment in severe cases of HELLP syndrome

HELLP syndrome is one of the important complications in pregnancy which increases the maternal mortality rate from 1.1 to 25% and the fetal mortality from 7.4 to 34%. This disease usually remits with supportive treatment which includes prescription of corticosteroid, magnesium sulfate, stabilization of mother and pregnancy termination. Plasmapheresis is a treatment of choice which improves clinical outcomes in complicated cases. A 22-year-old woman with coagulopathy and respiratory distress and 33-year-old woman with a history of cerebellar medulloblastoma and at 32 weeks of gestation developed thrombocytopenia who were treated with plasmapheresis are described. Plasmapheresis can significantly improve the patients with HELLP syndrome who are unresponsive to conservative therapy.